Provider Demographics
NPI:1790315786
Name:PATEL, LAXMIKANT DEVSHI (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:LAXMIKANT
Middle Name:DEVSHI
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8418 263RD ST
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-1104
Mailing Address - Country:US
Mailing Address - Phone:646-831-0194
Mailing Address - Fax:
Practice Address - Street 1:8418 263RD ST
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-1104
Practice Address - Country:US
Practice Address - Phone:646-831-0194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-19
Last Update Date:2020-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034222183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist